Blue Chair Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BLUE CHAIR COUNSELING LLC

Practice address

2921 Maryville Rd Ste B
Maryville, IL 62062-5400

Phone

(618) 920-1680

NPI assigned

Nov 21, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa M Fox, LCSWNPI 1184244261

Title

Member

Phone

(618) 920-1680

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa M Fox, LCSW

  • Clinical Social Worker
  • Swansea, IL
  • NPI 1184244261
  Medicare reassignment Care Compare group NPD Authorized official
• Darren Dunahee, MBA, MSW, LCSW

  • Clinical Social Worker
  • Maryville, IL
  • NPI 1053749432
  Medicare reassignment Care Compare group NPD
• Kathryn Schiber, MSW, LCSW

  • Clinical Social Worker
  • Maryville, IL
  • NPI 1306509120
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700524800000",
    "number": "1336914142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 MARYVILLE RD STE B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 MARYVILLE RD STE B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625400",
            "telephone_number": "618-920-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE CHAIR COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-21",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "618-920-1680",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Karl Berner, D.C.
• Aaron Biala, MD
• Jordan Overbey Bickhaus, DPT
• Michael Blackburn, RPH
• Sherri Blaha, CRNA
• Sharon E. Bonnell, OTR
• Tonya Ann Bosaw, NP
• Tamera J Bowles, LCPC ATR BC
• Jayme Boyer, APRN
• Diane Bracamontes, LCSW

• Clinical Social Worker in Maryville, IL
• Providers in Maryville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.